CPT® Code 55866

Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed

The CPT® Code 55866 refers to a laparoscopic surgical procedure known as retropubic radical prostatectomy, which is performed to remove the prostate gland and some surrounding tissue. This procedure can be conducted using either a transperitoneal or extraperitoneal approach. In the transperitoneal method, a small incision is made near the umbilicus to create an entry point for the laparoscope, which is a specialized instrument used to visualize the surgical area. Pneumoperitoneum, or the introduction of gas into the abdominal cavity, is established to create space for the surgeon to work. The laparoscope is then inserted, allowing for inspection of the abdominal cavity. Additional incisions are made to accommodate surgical instruments necessary for the procedure. The surgeon carefully dissects the tissue between the rectum and bladder to access the prostate, ensuring that critical structures, such as nerves, are preserved when possible, which is referred to as nerve-sparing surgery. The procedure involves meticulous steps, including the ligation of the dorsal vein, incision of the bladder neck, and dissection of the lateral pedicles, ultimately leading to the removal of the prostate and seminal vesicles. In cases where the extraperitoneal approach is utilized, the procedure begins with a small incision to insufflate the preperitoneum, allowing for the development of the retropubic space through blunt dissection. Robotic assistance may be employed during the procedure to enhance precision and control. The laparoscopic prostatectomy is a minimally invasive technique that aims to reduce recovery time and postoperative pain while achieving the same oncological outcomes as traditional open surgery.